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Keep Them Safe and Whole Family Teams - An Integrated Partnership Approach to Health Care

Mental Health and Drug and Alcohol Office (MHDAO)
Project Added:
18 February 2015
Last updated:
5 March 2015

Keep Them Safe and Whole Family Teams - An Integrated Partnership Approach to Health Care

Summary

Whole Family Teams (WFTs) include mental health and drug and alcohol clinicians working together in multidisciplinary teams to provide comprehensive mental health, drug and alcohol and family assessment and evidence informed individual and family in-home interventions for approximately six months. The model of care was informed by the best available evidence regarding interventions for families with complex mental health and drug and alcohol needs and the impact of these problems on the safety of their children.

The central theme of Keep Them Safe (KTS) is that care and protection for children and young people is a shared responsibility between families, communities, government and non-government organisations that work together to support and protect vulnerable children. This unique service model addresses the need for collaborative partnerships to stop families falling between the gaps.

This project was a finalist in the Integrated Health Care category of the 2014 NSW Health Awards.  Download a poster from the 2014 NSW Health Awards.

Aim 

To improve health outcomes, keep children safe, improve parenting skills and family functioning.

Benefits

  • Demonstrated improvements in parental mental health and parental drug and alcohol outcomes. 
  • Demonstrated improvements in family functioning (parenting, family relationships and child wellbeing).
  • Demonstrated improvements in child safety.
  • Improvements in collaborative practice between community services to deliver health care that meets the needs of families with mental health, drug and alcohol and child protection concerns.
  • Potential long term economic savings.
  • Deliver integrated, in-home interventions for the whole family. 
  • Enhanced collaboration with support services and agencies to ensure client service needs are met.

Project Status

Sustained: The project has been implemented and is funded under Keep Them Safe until June 2016.

The recent government announcement in the Strategic Plan for Mental Health in NSW made a commitment to three additional WFTs.

Background

Keep Them Safe is the NSW Government response to the Wood Commission of Inquiry into Child Protection Services in NSW. NSW Health was funded to improve child safety by supporting the needs of parents with mental health and drug and alcohol problems.

The unique WFT integrated outreach partnership model operates to prevent vulnerable families from falling through service gaps. The WFT is an innovative health model with no direct comparisons from national or international studies. The major features include mental health and drug and alcohol working together in multidisciplinary teams that provide specialist interventions, in the home, to families with a range of complex problems.

Families with complex needs often risk falling through service gaps. These vulnerable families also frequently miss out on services due to access and support issues.

Implementation 

WFTs address these complex needs by providing integrated, in-home interventions for the whole family. WFTs work collaboratively with support services and agencies to ensure that client service needs are met. A strong partnership with Community Services has been a critical success factor. 

WFTs are located in Gosford, Newcastle, Nowra and Lismore and provide integrated specialist health services in the home for families where there are drug and alcohol and/or mental health problems and where there has been a substantiated risk of significant harm report (ROSH). Referrals are primarily from community services.

Forty six specialist clinical staff are currently employed and provides services to over 200 vulnerable families with complex needs per year.

WFTs provide comprehensive mental health, drug and alcohol and family assessment and evidence informed individual and family in-home interventions for approximately six months. The model of care was informed by the best available evidence regarding interventions for families with complex mental health and drug and alcohol needs and the impact of these problems on the safety of their children.

The WFT model is an innovative partnership model of health care that provides seamless family focused interventions across different health settings with the primary aim of keeping children safe and improving parenting skills. Specialist clinicians work with families and service partners to improve health outcomes, family functioning and child safety. 

KTS-WFT clinicians help to reduce the risk of child protection concerns, increase parenting skills and help clients function more effectively.

The KTS-WFT key rationale is that by treating parental mental health and/or drug and alcohol issues, children who may otherwise be at risk of harm will be safe and able to thrive while at the same time addressing parenting capacity and child protection.

WFT programs located in rural and regional Local Health Districts (LHDs) adopt a holistic family partnership model where parents are valued and supported in their parenting role despite experiencing mental health and /or drug and alcohol problems and previous child protection concerns. 

Families are fully informed of the services WFTs provide and open and transparent communication is encouraged with all key partners. Interventions are aimed at empowering parents to develop the skills they need to improve their skills and better protect their children. Aboriginal and culturally and linguistically diverse (CALD) families are provided a tailored service.

Partnerships

Community Health Centres; Child Protection Counselling Services; specialist Mental Health, Drug and Alcohol Services; Aboriginal Health Services; Family and Community Services; Primary Health Care Services and private providers.

Implementation sites

WFTs are located in Gosford, Newcastle, Nowra and Lismore.  

Results 

An independent evaluation1 reported that the WFT model is working well, requiring minimal refinement. KTS funding has been extended for two years to June 2016 and across this period teams will expand WFT impact by extending the geographical reach, with some LHDs moving to a hub and spoke model. This will also increase the locations and number of Community Service Centres able to refer families to WFTs.

More than 200 families with complex needs have been provided a specialist health service each year. An economic analysis based on case study evaluation data suggests that WFTs may have potential long-term positive economic impacts that outweigh the program’s costs. A formal cost effectiveness analysis, subject to data availability, would be useful and quantify this during the next two year phase.

The independent KTS-WFT Final Reportfound a statistically significant (58.4%) reduction in the mean rate of Risk of Significant Harm reports for children in families who completed the WFT program.

Consistent and statistically significant improvements across a range of clients interviewed as part of the WFT evaluation reported they valued the interventions, such as clear communication, a non-judgmental, sensitive and consultative approach and home visiting, that addressed their mental health or drug and alcohol problems enabled them to become a better parent and improve their capacity to meet the needs of their children.

Lessons Learnt 

The KTS-WFT Final Report1 found that there is compelling evidence to suggest that the WFT model of an intensive home based specialist service providing tertiary level mental health and drug and alcohol interventions for parents and early intervention for children improves child safety and wellbeing through addressing family functioning and parental ability to care for children.

An essential key to the success of the WFT model has been the building and sustaining of partnerships with key stakeholders over the past five years. Examples include staff attending regular community service meetings, joint initial assessments and reciprocal education and training sessions.

The annual WFT Forum, where community service staff and WFT staff come together to discuss strategies to improve the model of care; data and reporting and strengthening collaboration with key stakeholders. In the evaluation report, Community services staff highlighted the importance of WFTs maintaining their unique role as a specific referral pathway for these complex families.

References 

  1. Keep Them Safe-Whole Family Teams Final Report (2014) – unpublished.
  2. NSW 2021: A plan to make NSW number one sets the Government's agenda for change in NSW, Dept. of Premier and Cabinet (2011)
  3. Keep Them Safe: A shared approach to child wellbeing, Department of Premier and Cabinet, NSW Government (2009).

Contact

Bernadette Dagg
Keep them Safe Project Manager/Interagency Manager
Mental Health and Drug and Alcohol Office (MHDAO)
NSW Ministry of Health
Phone: 02 9816 0439
Email: bdagg@doh.health.nsw.gov.au

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